Gum Disease Can Harm Much More Than Your Teeth

Periodontal problems could aggravate other ailments, such as diabetes and heart disease

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THURSDAY, June 15, 2006 (HealthDay News) -- Proper oral hygiene may do a lot more than keep your teeth bright and cavity-free -- it could be a boon to your overall health.

A growing body of research suggests that periodontal disease may exacerbate a variety of health problems as wide-ranging as diabetes, heart disease, respiratory disease -- even premature births, experts say.

For instance, several promising studies have found that blood-sugar levels in diabetics with periodontal disease were reduced to normal when the patients' gum disease was treated. Other research revealed that the incidence of respiratory diseases among nursing-home residents was cut when they were treated for gum disease, said Dr. Robert Genco, distinguished professor of oral biology at the School of Dental Medicine at the State University of New York at Buffalo.

"All of these are pilot studies, and whether [the periodontal disease] is causal, we cannot say, but we can't ignore these associations," Genco said. "Further, from a practical standpoint, there is no harm in treating periodontal disease in these patients."

Gum disease is very common, Genco explained. Approximately 80 percent of Americans have some form of the condition, which is a bacterial infection of the gums surrounding the teeth.

Gingivitis is the mildest and most common form of gum disease, causing inflammation of the tissues around the teeth. More serious is periodontitis, when the inflammation affects the connective tissue supporting the teeth and, eventually, the bone. An estimated 20 percent of Americans have periodontitis, making it the primary cause of tooth loss in adults.

Because periodontal disease is so common, Genco said, treating the condition successfully could have a significant impact on public health, even if it's associated with only a small portion of other ailments.

One reason gum disease could contribute to other ailments, researchers say, may be that oral bacteria get into the bloodstream and cause inflammation of other body tissues. Another possibility is that an oral infection could trigger inflammatory responses from the immune system, adversely affecting the rest of the body.

Dr. Steven Offenbacher, distinguished professor at the Department of Periodontics at the University of North Carolina School of Dentistry, is studying the link between periodontal disease and preterm birth, and thinks inflammation could play an important part in the connection.

"Organisms are capable of invading the bloodstream and challenging the fetus by inflammation of the fetal and placenta unit, thus promoting premature birth," he said.

In monitoring the dental health of 1,020 pregnant women, Offenbacher and his colleagues found that those who suffered moderate-to-serious periodontal disease (14 percent of the women) were twice as likely to give birth to premature babies, than women with healthy gums. This difference held up even when the results were adjusted to reflect factors such age of the mother, prior preterm births and socioeconomic differences.

Offenbacher is now the lead investigator of a five-year, multi-center study that's enrolling 1,800 pregnant women and treating their periodontal disease, to see if the treatment reduces the risk of premature delivery. Within three years, he said, there will be good data showing whether or not treating gum disease can reduce preterm birth risk.

"We have not yet proven [a link] but the data suggests that treating the mother is safe and can improve dental health," he said.

Meanwhile, growing interest in the possible links between periodontal disease and other illnesses has prompted study into more aggressive treatment of gum disease.

"Periodontal disease is a silent disease. The signs are not that obvious, and people really don't know they have problem," Genco said.

Doctors with patients with diabetes, respiratory illnesses, heart disease as well as pregnant women would all benefit from awareness of the possible effects of periodontal disease on the conditions they're treating, he said.

To help them and their patients recognize the signs of periodontal disease, Genco is one of several health professionals working with the U.S. Centers for Disease Control and Prevention. The goal: To develop a simple questionnaire for doctors to give their patients that would suggest when a patient should be seen by a dentist.

Answering "yes" to questions like whether their gums bleed or if their teeth look different could indicate which patients might have gum disease and should be referred to a dentist.

"People know when their gums recede -- there can be discoloration. Or if there is a difference in the spacing of their teeth or if their teeth look different," he said.

SOURCES: Robert Genco, D.D.S., Ph.D., distinguished professor of oral biology, School of Dental Medicine, State University of New York at Buffalo; Steven Offenbacher, D.D.S., Ph.D., M.S., distinguished professor, Department of Periodontics, University of North Carolina School of Dentistry, Chapel Hill, N.C.